The Journal of Bone and Joint Surgery (American). 2005;87:715-724.
doi:10.2106/JBJS.C.01344
© 2005 The Journal of Bone and Joint Surgery, Inc.
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Transplantation of Viable Meniscal Allograft

Survivorship Analysis and Clinical Outcome of One Hundred Cases

Peter C.M. Verdonk, MD1, Alex Demurie, MD1, Karl Fredrik Almqvist, MD, PhD1, Eric M. Veys, MD, PhD1, Gust Verbruggen, MD, PhD1 and René Verdonk, MD, PhD1

1 Departments of Physical Medicine and Orthopaedic Surgery (P.C.M.V., A.D., K.F.A., and R.V.) and Rheumatology (E.M.V. and G.V.), Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. E-mail address for P.C.M. Verdonk: pverdonk{at}yahoo.com

Investigation performed at the Departments of Orthopaedic Surgery and Rheumatology, Ghent University Hospital, Ghent, Belgium

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the Fund for Scientific Research (F.W.O.-Vlaanderen), Flanders, Belgium. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Few medium-term or long-term reports on meniscal allograft transplantations are available. In this study, we present the results of a survival analysis of the clinical outcomes of our first 100 procedures involving transplantation of viable medial and lateral meniscal allografts performed in ninety-six patients.

Methods: Thirty-nine medial and sixty-one lateral meniscal allografts were evaluated after a mean of 7.2 years. Survival analysis was based on specific clinical end points, with failure of the allograft defined as moderate occasional or persistent pain or as poor function. An additional survival analysis was performed to assess the results of the sixty-nine procedures that involved isolated use of a viable allograft (twenty of the thirty-nine medial allograft procedures and forty-nine of the sixty-one lateral allograft procedures) and of the thirteen viable medial meniscal allografts that were implanted in combination with a high tibial osteotomy in patients with initial varus malalignment of the lower limb.

Results: Overall, eleven (28%) of the thirty-nine medial allografts and ten (16%) of the sixty-one lateral allografts failed. The mean cumulative survival time (11.6 years) was identical for the medial and lateral allografts. The cumulative survival rates for the medial and lateral allografts at ten years were 74.2% and 69.8%, respectively. The mean cumulative survival time and the cumulative survival rate for the medial allografts used in combination with a high tibial osteotomy were 13.0 years and 83.3% at ten years, respectively.

Conclusions: Transplantation of a viable meniscal allograft can significantly relieve pain and improve function of the knee joint. Survival analysis showed that this beneficial effect remained in approximately 70% of the patients at ten years. This study identified the need for a prospective study comparing patients with similar symptoms and clinical findings treated with and without a meniscal allograft and followed for a longer period with use of clinical evaluation as well as more objective documentation tools regarding the actual fate of the allograft itself and the articular cartilage.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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